EXPANDED FUNCTIONS FOR DENTAL ASSISTANTS NOTE:

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1 EXPANDED FUNCTIONS FOR DENTAL ASSISTANTS NOTE: While the information contained in this chart is of general interest, one cannot rely on this chart to obtain a number of states that allow a particular function because the information presented here is a snapshot at a particular point in time and may not be completely up-to-date. See the end of this document for a more complete statement. Note also that there may be a discrepancy in the way states characterize "expanded functions." For example: one state may consider coronal polishing an expanded function, and another may consider it a regular function. Two helpful resources that are more thorough and timely than this document are: (1) The current ADA Survey of Legal Provisions for Delegating Intraoral Functions to s and Dental Hygienists and (2) Dental Assisting National Board, Inc. (DANB) publication of their annual State Fact Booklet an annual compilation of all states statutes and regulations applicable to dental assistants. The following states authorize a dental assistant to perform functions which are beyond the scope of an assistant's "traditional" duties, as defined by the state and which generally require specific training 1/ *This information is accurate according to the records available to DSGA and may not wholly reflect the current status. Supervision as listed under Qualifications refers to that of a licensed dentist unless specifically indicated otherwise. STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* ALABAMA Various ortho functions, take x-rays, apply topical agents (but not sealants), help administer nitrous oxide Direct supervision ALASKA Coronal Polishing Restorative Functions ARIZONA Place interim restorations, place amalgam, apply fluoride varnish and sealants, monitor nitrous oxide, coronal polishing ARKANSAS Registered Monitor nitrous oxide, coronal polishing Direct Supervision - approved course Direct supervision - CODA accredited program, WREB s restoratives exam. Direct Supervision General supervision & DANBapproved course(s) and exam(s) Personal supervision & approved course Approved course and exam Registered (RDA)Dental American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 1

2 STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* CALIFORNIA Section Bus. & Prof. Code (DA) Registered (RDA) Registered dental assistant in extended functions. (RDAEF) This category expires in DA - Perform basic supportive services that are completely reversible. Assist in administering nitrous oxide, take x-rays. Unlicensed. RDA - Placement of restoratives and placement sealants under general supervision. Licensed RDAEF All duties of an RDA plus Perform charting, preliminary assessments of oral health; examine soft tissue and oral health assessments in school-based, community health project settings. Placement sealants under general supervision and the placement of restoratives. Licensed DA - Supervision (required for all levels of assistants); approved radiation safety course; courses in CA Dental Practice Law, BLS, infection control. RDA - Work experience and approved courses in allowed duties, radiation-safety, infection control, dental law, and BLS. Written and clinical exam. CE course work, written and clinical exams and CE. RDAEF - Approved courses in allowed duties, radiation-safety, infection control, dental law, and BLS. Written and clinical exam. CE. Works at the direction & direct supervision of dentist or RDH or RDHAP. Unlicensed Registered (RDA) Registered Qualified In or To Perform Expanded/Extended Duties/ Functions (RDAEF) Orthodontic Permit Oral Surgery/Periodontal Practices Permit Orthodontic duties set forth in law. Oral Surgery/Periodontal Duties set forth in law Courses in orthodontic assisting, infection control, dental law, and BLS. Written and clinical exam. CE 12 mos. work experience, CE. COLORADO Apply topical agents, coronal polishing Denture services, administer nitrous oxide Take X-rays Indirect supervision. Direct supervision. For x-rays 5 hours of experience and 3 hours lecture or DANB Radiation Health & Safety Exam. Expanded Duties -EDDA Some dental assistants in the state of Colorado may choose to complete an EDDA education program. The EDDA designation is NOT recognized by the Colorado State Board of Dentistry and does not qualify a dental assistant to perform expanded duties in the state. American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 2

3 STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* CONNECTICUT Supervision and DANB RHS Exam DELAWARE Dental Auxiliary Various, including take x-rays Must have State Certificate to take x-rays or alternatively DANB CDA credential or RHS exam that constitutes equivalence of state certification. FLORIDA, apply topical fluoride Indirect supervision and formal training. Expanded Duty Dental Monitor nitrous oxide, coronal polishing, remove sutures. Direct supervision. Formal training. Expanded Function(s) - GEORGIA Ortho functions, coronal polishing Direct supervision Expanded Duty Dental Monitor nitrous oxide, apply sealants Direct supervision and approved coursework and certificate. Expanded Duties -EDDA HAWAII, monitor nitrous oxide Direct supervision IDAHO, fluoride application Direct supervision ILLINOIS Expanded Function(s) Dental - Temporary crowns, coronal polishing, monitor nitrous oxide, apply sealants Direct supervision and Boardcertification. Supervision following coursework or on-the-job training. Expanded Function(s) - Qualified In or To Perform Expanded Duties/Functions Monitor nitrous oxide administration Coronal polishing, apply sealants Supervision, CPR certification, and completion of approved coursework. Supervision and completion of approved coursework and clinical experience. Qualified In or To Perform Expanded Duties/Functions American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 3

4 STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* INDIANA Dental assistant Operate x-ray equipment, place, & condense amalgam, place & finish composite IOWA KANSAS Trainee Registered (Licensed) Registered with Expanded Duties Training with Expanded Duties Training Various tasks Sealants, coronal polishing, dental radiography Monitor nitrous oxide, place temporary restorations, take impressions Coronal polishing, place & condense amalgam, place & finish composite Coronal scaling Administer and monitor nitrous oxide DANB RHS or CDA exam plus state-run on-the-job training program or ADA-approved college dental assisting program to obtain state x-ray operator equipment license. On-the-job training under personal supervision. Within 12 months, completion of a board-approved course of study and boardapproved exam to become a registered DA. All dental assistants must be licensed (registered) and work under supervision. DAs are required to pass board-approved exams and take CE. 2 years experience Board-approved course Direct supervision & dentistprovided training Certificate from an approved course. CPR certification, board-approved course Trainee Registered (RDA) Registered with Expanded Duties Training with Expanded Duties Training KENTUCKY Dental Auxiliary Various tasks, place & condense amalgam, place & finish composite LOUISIANA Registered Coronal Polishing, take x-rays Supervision & approved coursework & DANB RHS exam. Coronal Polishing-approved coursework or certification and 1 year clinical office experience. Direct supervision Expanded Duty Dental Place or remove matrices, temporary separating devices, periodontal dressings, retraction cords; apply sealants Direct supervision. High school diploma or equivalent & completion of approved DA program. Expanded Duties -EDDA American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 4

5 STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* MAINE Certified Various including coronal polishing, suture removal, pouring and trimming dental models, fabricate temporary restorations, removal of composite using slow-speed handpiece to de-bond brackets. Above duties plus taking x-rays, temporary restorations; Supervision required (general or direct depending on task). General supervision and DANB RHS or CDA EXAM for eligibility for board licensure as Dental Radiographer operator. Board approved training program, DANB Certified (CDA ) Expanded Function DAs rules adopted 2007 All of the above plus, place and carve restoratives prior to final curing.; apply topical fluorides and sealants; Be a Certified or licensed as a dental hygienist; and complete a Board approved CODA accredited program; jurisprudence exam; CPR certificate; certification as by endorsement approved. 50 hours CE every 5 years required. Expanded Function(s) - MARYLAND Recognized as Qualified in Orthodontics Ortho functions Direct supervision, approved coursework, DANB RHS exam and registration with board Direct supervision, approved program and DANB CDA or COA exam or Maryland Ortho Assisting exam. Qualified in General Duties American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 5

6 MASSACHUSETTS Certified (CDA) Certified Oral & Maxillofacial Surgery s(fta) Certified Ortho s (COA) Coronal polishing, assist in administering nitrous oxide, place sealants. Different categories of DA can perform different functions, or similar functions with differing levels of supervision including place amalgam. General supervision, certification, and in some cases completion of DANB exam is required to take radiographs and perform other expanded functions. DANB Certified (CDA ) Formally-Trained Certified Ortho s (COA) On-The-Job Trained Dental (OJT) On-The-Job Trained (Expanded Function Dental () means a person who is a graduate of a school or program for dental assistants accredited by the Commission on Dental Accreditation, is currently certified by the Dental Assisting National Board, Inc., or its successor agency, and has completed a formal program in expanded functions at a program accredited by the CODA. STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* MICHIGAN Registered Ortho functions Radiography, coronal polishing, assist in admin & monitor nitrous oxide, various other duties General or direct supervision General or direct supervision, approved program and board exam Registered (RDA) MINNESOTA (unlicensed) Licensed Various basic duties Various, including taking x-rays, administering and monitoring nitrous oxide, coronal polishing, ortho tasks, placing temporary restorative materials, place and carve amalgam, place & finish composite Personal dental supervision. All regulated dental assistants must be current in CPR at the Health Care Provider level May work with general supervision; approved program and exam Licensed (LDA) American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 6

7 MISSISSIPPI s, place amalgam Direct supervision, radiology permit is required MISSOURI Certified Qualified In or To Perform Expanded Duties/Functions (s must register with the dental board.) Help administer and monitor nitrous oxide Place restorative material for Class I, V, and V1 preparations; air-polish crowns, take x-rays. Approved program and exam Approved program and exam Certification or completion of the Missouri Basic Dental Assisting Skills Mastery Examination AND a Missouri board-approved expanded functions course AND completion of an approved competency exam. DANB Certified (CDA ) Qualified In or To Perform Expanded Duties/Functions MONTANA Dental Auxiliaries Polish coronal surfaces Various ortho functions Various NEBRASKA s, coronal polishing, monitor nitrous oxide, place amalgam Direct supervision and Approved course Approved program and exam Approved program and exam Indirect supervision, approved program & 1-year experience as a DA. Dental Auxiliary STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* NEVADA, coronal polishing, apply sealants, ortho-related tasks NEW HAMPSHIRE s Certified & Graduate Basic supportive procedures Apply fluoride, topical anesthesia and bleaching agents Supervision; dentist must ensure formal or on-the-job training for assistants who take radiographs Approved program from accredited school DANB Certified (CDA ) & Graduate Qualified Above, and take x-rays, apply sealants, perform ortho related functions Approved course and board exam Qualified In or To Perform Expanded Duties/Functions American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 7

8 NEW JERSEY Unregistered dental assistant Registered Various, monitor nitrous oxide, coronal polishing, place amalgam DANB Certified for X-Rays, Direct supervision, approved course and hold a NJ Dental Radiologic License. Direct supervision, Boardapproved course, exam Unregistered Registered (RDA) NEW MEXICO Limited Registered dental assistant in orthodontics Ortho functions, prepare work order for emergency prosthesis repair. Basic supportive procedures Direct supervision, approved course and CE for nitrous oxide monitoring; other functions require approved coursework or 2 years experience Supervision, approved program and continuing education Certified for Dental Radiography Supervision, approved program, exam and continuing education NEW YORK Certified Sealants; coronal polishing; fluoride varnish Basic supportive procedures Same Direct personal supervision. with State Certification in Expanded Functions Unlicensed State-licensed certified dental assistant Ortho, x-ray; any reversible, noninvasive supportive procedure. Supervision, approved courses, exam State-licensed certified dental assistant DANB Certified (CDA ) with a Limited Permit Approved courses,, direct personal supervision, one year permit, renewable once with a Limited Permit STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* NORTH CAROLINA I II. Help administer nitrous oxide Make impressions, apply sealants, coronal polishing Approved course, clinical experience, and equivalency exam. Approved course or clinical experience. Formal education or experience. I II DANB Certified (CDA ) In NC there are only 2 classifications of DAs (DAI and DAII) NORTH DAKOTA s Basic Supportive functions On the job training Qualified s, basic supportive functions On the job training, and board American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 8

9 approved infection control and X- ray course and pass DANB exam. Qualified Registered (Certified DAs), ortho, monitor nitrous oxide, coronal polishing, take impressions for athletic mouthguard and passive posttreatment retainers. Any alternative (a) a CODA accredited DA course; (b) North Dakota Board of Dental Examiners-approved DA course; (c) Certified by DANB plus 3000 hours of DA instruction including on the job training. In addition annual CE and registration Registered (RDA) OHIO Advanced Qualified Personnel (Expanded Function Dental Auxiliaries) Radiographer Place sealants. Place & contour restorative materials, sealants, monitor nitrous oxide, coronal polishing. Board approved course and be a registered DA. Direct supervision, graduation from an accredited program, board approved competency exam and BLS certification. DANB or Board approved exam & license Expanded Function(s) Dental Auxiliary Certified Basic Qualified Personnel Sealants, coronal polishing Basic supportive procedures Supervision, approved courses, exam Direct supervision and responsibility, trained directly by employer DANB Certified & (CDA )& Certified Ohio Basic Qualified Personnel STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* OKLAHOMA Basic supportive procedures On-the-job training and direct supervision. Expanded Duty Dental : four types of Expanded Duty Permits required to perform specified duties. Radiation safety permit; coronal polishing/topical fluoride permit, Sealants permit, Nitrous Oxide permit Each type of permit has specific formal education requirements. Expanded Duties -EDDA OREGON Expanded Function Dental Various, Coronal polishing of all ages including kids < 12 years of age with no calculus. Place sealants. Supervision and: Approved course and exam Approved course (may be inoffice) and exam Expanded Function(s) - American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 9

10 Orthodontic and Expanded Function Ortho Asst. Certified Anesthesia Dental Various ortho functions Various duties as assigned. Approved course (may be inoffice) and exam; DANB exam; BLS/CPR certification Restorative Functions Dental Place and finish direct alloy or direct anterior composite restorations Informed consent of patient; Board approved and accredited curriculum the Western Regional Examining Board's Restorative Examination PENNSYLVANIA Expanded Function Dental Place and remove rubber dams and matrices, place and contour amalgam and other restorative materials, place sealants, polishing teeth, applying fluoride treatments. Direct supervision, formal education and exam or 5 years prior experience and exam Expanded Function(s) - RHODE ISLAND Various Supervision. Certified Sealants, Coronal polishing Supervision and academic training, DANB-CDA exam. DANB Certified (CDA ) American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 10

11 STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* SOUTH CAROLINA Expanded Duty Dental. Various. Coronal polishing, monitor nitrous oxide, place temporary restorations, apply sealants. Direct supervision and boardapproved radiation safety course. Direct supervision; certificate from approved program or 2 years chairside experience Expanded Duties -EDDA SOUTH DAKOTA Advanced Coronal polishing; supragingival scaling (per 2004) Survey of Delegable Duties Take X-rays Direct supervision; Graduation from approved DA school or DANB-CDA & dental board course Advanced TENNESSEE Practical Registered Various Monitor nitrous oxide, coronal polishing, apply sealants Direct supervision, on-the-jobtraining Direct supervision, training, exam, Board permits Practical Registered (RDA) Certified All the above plus take final impressions and place and contour restoratives. Direct supervision, training, exam, Board permits TEXAS Registered s DAs who are Sealant Certified Prep teeth for & apply sealants UTAH Coronal polishing, help administer nitrous oxide VERMONT Traditional Register with Board, Certified by DANB and pass board exam. CE. 2 yrs. experience, 16 hours clinical & didactic instruction, 6 hrs CE annually Direct Supervision Approved course and exam Supervision and: Special Board endorsement Registered (RDA) Qualified In or To Perform Expanded Duties/Functions Traditional Certified Expanded Function Dental Functions for which CDA is trained Coronal polishing Functions for which is trained including placing & condensing amalgam and place & finish composite DANB Exam Formal training in CODA-approved program DANB Certified (CDA ) Expanded Function(s) - American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 11

12 STATE TITLE EXPANDED FUNCTIONS(S) QUALIFICATIONS DANB JOB TITLES* VIRGINIA Apply fluoride or desensitizing agent, Coronal polishing Supervision, approved training and certificate Supervision, approved course and/or exam II (essentially an ) DA II functions include Performing pulp capping procedures; 2. Packing and carving of amalgam restorations; 3. Placing and shaping composite resin restorations; 4. Taking final impressions; DA II Qualifications include specified hours of didactic education, clinical training and experience and examination in modules for the performance of specific duties delegated under direct supervision. DANB certified. 5. Use of a non-epinephrine retraction cord; and 6. Final cementation of crowns and bridges after adjustment and fitting by the dentist. WASHINGTON Registered RDA Monitor nitrous oxide, ; coronal polishing; apply sealants Close supervision (Registration required as of July 1, 2008). Registered (RDA) Expanded Function Dental Above functions under general supervision. Place and carve restoratives; take final impressions under close supervision. Licensure - requirement completing CODA DA program or DANB certification plus experience. (See 2007 HB 1099). Licensed Expanded Function Dental Auxiliary WEST VIRGINIA School Sealant DA Rules define a Noncredentialed person Apply sealants and fluoride varnish Duties not clear probably basic dental assisting Place topical fluoride, apply sealants, place retraction cord, coronal polish, place temporary space maintainers for ortho purposes, monitor nitrous oxide administration General supervision. Close supervision. Direct supervision Board-approved course and exam Qualified In or To Perform Expanded apply anti-cariogenic agents, apply pit and fissure sealant, apply acid etch, Direct supervision American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 12 Qualified In or To Perform Expanded Duties/Functions

13 Duties/Functions coronal polishing, place retraction cords, monitor nitrous oxide Board-approved course and exam WISCONSIN Coronal polishing None WYOMING Coronal polishing but not as a prophy procedure. Various. Take X-rays Supervision. X-Ray approved course or experience or DANB-CDA exam Note: Sources of information State laws, and regulations, and ADA Survey of Legal Provisions for Delegating Intraoral Functions to s and Dental Hygienists ; Dental Assisting National Board s (DANB) State Fact Booklet; DANB exams; CDA=Certified ; RHS=Radiation Health & Safety; ICE=Infection Control Exam; COA=Certified Orthodontic Exam. *DANB reports these job titles for each state, which was taken from position paper of the ADAA/DANB Alliance: Addressing A Uniform National Model For the Dental Assisting Profession, September The ADA has not verified these titles. Statement of how this document was compiled - Dental Practice Acts and Board regulations were reviewed to obtain a snapshot of some of the functions dental assistants are allowed to perform and the level of education, training, certification or licensure required. This is not comprehensive. The information in this document is limited to what is found in state dental practice acts and dental board regulations. State Laws and regulations are ever changing the material in this document may not be the most current. Policies of dental boards, opinions of state attorneys general, and court decisions may have an effect on how these laws are interpreted. You are advised to contact the dental board for the state of your interest to determine how the laws and regulations are applied in that state. If you believe any of the information contained herein needs updating please contact the ADA Department of State Government Affairs. A comprehensive resource is the State Fact Booklet from the Dental Assisting National Board that is available for purchase by calling FOR-DANB. American Dental Association, Department of State Government Affairs, March 28, 2011, #11-Expanded Functions s Pg. 13